Treatment for Little League Elbow in Children and Teens

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Contact the Hand and Orthopedic Upper Extremity Program

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When should an orthopedist or sports medicine specialist be consulted?

Any persistent elbow pain in the young throwing or overhead athlete should be evaluated by an orthopedist or sports medicine specialist.

Most athletes with Little League elbow can be treated with rest and physical therapy, but in more serious cases, surgery is needed.  

Treatment without surgery

   •   The most important part of Little League elbow treatment is rest. Your child
       should not throw at all until his tendons, ligaments and growth plates are fully healed.
   •   Often, icing the elbow multiple times a day can help reduce inflammation until there is no pain.
   •   Your doctor may also prescribe physical therapy, which can help strengthen the muscles around the elbow.

Surgery

   •   If your child's elbow problem is because of a single, painful accident, then surgery may be necessary. The kind
       of surgery required depends on your child's specific problem and the seriousness of the injury.
   •   It might involve attaching the ligaments back to the bone or making sure there are no more loose bone. 
   •   Recovery usually lasts two to three months, and involves follow-up appointments, physical therapy and a very
       careful, gradual return to throwing.

Tommy John surgery refers to reconstruction of the ulnar collateral ligament (UCL) of the elbow.

How can parents and coaches prevent UCL injuries?

Prevention is worth a pound of cure, and this is certainly true of UCL injuries such as Little League elbow in young throwers.

Following USA Baseball's guidelines regarding pitch counts and types of pitches thrown is important. Attention to throwing mechanics and conditioning of the lower body, core, shoulder and elbow is also important. In addition, year-round baseball participation on multiple teams increases the risk of elbow injuries like UCL tears. Finally, athletes should not throw in pain.

Learn more about preventing common baseball injuries with Boston Children’s Injury Prevention guide.

More information is also available in a Sports Illustrated feature about Boston Children's approach to Tommy John surgery.

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- Sandra L. Fenwick, President and CEO

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